Manual actuator for a robotic medical system

Abstract

A surgical instrument comprising: a surgical effector having a wrist configured to manipulate an object at a surgical site; one or more robotically-operable input controllers configured to open and close the wrist of the surgical effector; and a manual actuator configured to open and close the wrist of the surgical effector.

Description

[0001] Cross-referencing

[0002] Any and all applications that identify foreign or domestic priority claims in the application data sheet filed with this application are incorporated herein by reference in accordance with 37 CFR 1.57. Technical Field

[0003] The systems and methods disclosed herein relate to medical robots, and more specifically to manual actuators for robotic medical systems. Background Technology

[0004] Robotics has a wide range of applications. Specifically, robotic arms help perform tasks that humans would normally do. For example, factories use robotic arms to manufacture cars and consumer electronics. Additionally, scientific facilities use robotic arms to automate laboratory processes such as transporting microplates. More recently, physicians have begun using robotic arms to assist in performing surgical procedures. For instance, physicians use robotic arms to control surgical instruments (such as laparoscopes).

[0005] Laparoscopes with movable tips facilitate minimally invasive surgical procedures. These tips can be guided through the abdominal wall to more distant locations within the patient's body, such as the intestines or stomach. In robotic laparoscopy, the movable tips possess several degrees of freedom, mimicking the surgeon's wrist in traditional surgical procedures. These movable tips (also known as robotic wrists or simply wrists) have evolved with technology and encompass a variety of techniques to create as many degrees of freedom as possible while using a minimal number of surgical instrument motors.

[0006] Many such robotic wrists use pre-tensioned cable loops. This allows the device to be driven with a minimal number of motors, compared to devices where each cable is tensioned by a motor. This type of "closed-loop" wiring system makes it more difficult to map motor torque to cable tension. This is partly due to the preload in the system and partly due to friction caused by the preload. The end of the lifespan of pre-tensioned devices is typically due to the cables losing tension over time due to a combination of mechanical wear, the effects of cleaning chemicals, and cable stretching. Attached Figure Description

[0007] The disclosed aspects will be described below in conjunction with the accompanying drawings, which are provided to illustrate and not limit the disclosed aspects, wherein similar reference numerals denote similar elements.

[0008] Figure 1 An exemplary representation of a surgical robotic system is shown.

[0009] Figure 2 An exemplary representation of a slave device in a master / slave surgical robot system is shown.

[0010] Figure 3 An exemplary representation of the end of a robotic arm coupled to a surgical instrument in a master / slave surgical system is shown.

[0011] Figure 4 An exemplary representation of surgical instruments in a master / slave surgical system is shown.

[0012] Figure 5 An isometric view of an exemplary support bracket showing its components is shown.

[0013] Figure 6A An exemplary representation of a reciprocating pantograph for surgical instruments is shown.

[0014] Figure 6B An exemplary representation of the tension state of a reciprocating telescoping mechanism of a surgical instrument in a master / slave surgical system is shown.

[0015] Figure 6C An exemplary representation of different stretching states of surgical instruments in a master / slave surgical system is shown.

[0016] Figure 7A An exemplary representation of a surgical actuator is shown.

[0017] Figure 7B An exemplary representation of a surgical actuator with the actuator housing removed is shown.

[0018] Figure 8 An exemplary connection between an input controller and a surgical actuator of a surgical instrument is shown in a master / slave surgical system.

[0019] Figure 9A An example of a surgical actuator in a neutral state is shown.

[0020] Figure 9B The first and second yaw angles of the surgical actuator are shown as they increase.

[0021] Figure 9C Different examples of surgical actuators in a neutral state are shown.

[0022] Figure 9D The pitch angle of the surgical actuator is shown as it increases.

[0023] Figure 10A An example of a surgical instrument with all cable connections is shown.

[0024] Figure 10B An example of reciprocating motion in a surgical instrument is shown as the first yaw angle increases.

[0025] Figure 10CAn example of reciprocating motion in a surgical instrument is shown as the first pitch angle increases.

[0026] Figure 11 An exemplary alternative wiring for the wrist is shown.

[0027] Figure 12A An example of a manual actuator for surgical instruments is shown when the manual actuator is in the first actuation state.

[0028] Figure 12B An example of a manual actuator for surgical instruments is shown when the manual actuator is in the second actuation state.

[0029] Figure 13 An example of a manual actuator for a surgical instrument is shown, which is configured as a slider that can move along a slot in the cover of the surgical instrument.

[0030] Figure 14A An example of a manual actuator for surgical instruments is shown when the cover is in the first position.

[0031] Figure 14B An example of a manual actuator for surgical instruments is shown when the cover is in the second position. Detailed Implementation

[0032] This specification relates to a robotic surgical wrist with three degrees of freedom (DOF) that maintains the length and tension of cables controlling those DOFs throughout the surgical procedure.

[0033] Surgical robotic systems that control the wrist often employ a master / slave system, where the master device controls the movement of the slave device from a remote location. Typically, the slave device is a robotic surgical instrument that approximates a classic surgical tool used for surgical procedures, such as forceps in laparoscopy.

[0034] In one embodiment, the surgical instrument includes a surgical actuator for performing surgical procedures at the surgical site. This actuator has three degrees of freedom in motion: pitch, a first yaw, and a second yaw. Additionally, the actuator has a "fourth degree of freedom," which is a measure of the relative yaw angle and the tension of its corresponding cable within the actuator. The actuator also has a translational degree of freedom along an operating axis controlled by an external arm and a rotational degree of freedom about the operating axis controlled by an external instrument device manipulator.

[0035] To control the degrees of freedom of a surgical actuator, the surgical instrument comprises a group of four input controllers, four cables, a reciprocating telescoping mechanism, a cable reel, and the surgical actuator. Two cables connect to two pairs of input controllers via the surgical actuator, such that actuation (e.g., winding or unwinding) of these two pairs of input controllers manipulates the length of the cable segment to generate movement of the surgical actuator with respect to its degrees of freedom. The other two cables connect these two pairs of input controllers to the reciprocating telescoping mechanism, such that the movement caused by the actuation of the surgical actuator induces reciprocating motion within the reciprocating telescoping mechanism. The reciprocating telescoping mechanism maintains a constant cable length between each pair of input controllers by rotating the reciprocating telescoping mechanism.

[0036] The surgical wrist can be controlled by a computer program designed to interpret the user's movements as surgical maneuvers at the surgical site. The computer program interprets the user's movements and generates a set of instructions that, via a winding and unwinding input controller, appropriately manipulate four cables to translate the user's movements into movements of the surgical actuator.

[0037] For illustrative purposes, various embodiments will be described below in conjunction with the accompanying drawings. It should be understood that many other specific embodiments of the disclosed concepts are possible, and various advantages can be achieved using the disclosed specific embodiments. Titles are included herein for reference and to aid in locating the various sections. These titled sections are not intended to limit the scope of the concepts described therein. Such concepts may be applicable throughout the specification.

[0038] I. Surgical Robotic Systems

[0039] Figure 1 An exemplary representation of a master / slave surgical robot system 100, including a master unit 110 and a slave unit 150, is shown. Typically, the master unit is a command console for the surgical robot system 100. The master unit 110 includes a console base 112, a display module 114 (e.g., a monitor), and control modules (e.g., a keyboard 116 and a joystick 118). In some embodiments, one or more functions of the master unit 110 may be integrated into the slave unit 150 of the surgical robot system 100 or communicatively coupled to another system of the surgical robot system 100. A user 120 (e.g., a physician) uses the master unit 110 to remotely control the surgical robot system 100 from an ergonomic position.

[0040] The device 150 has a table base 152 for supporting a surgical table 154, on which a patient 156 is positioned for a surgical procedure at a surgical site 158. At least one robotic arm 160, mounted to at least one positionable base 162 for manipulating a surgical actuator 164, is positioned adjacent to the table base 152 and the surgical table 154. The robotic arm 160 may be coupled to the table base 152, rather than having a separate and movable positionable base 162. The table base 152 and the surgical table 154 may include motors, actuators, or other mechanical or electrical devices for changing the orientation of the surgical table. In some embodiments, the table base 152 and the surgical table 154 may be configured to change the orientation of the patient 156 and the surgical table for different types of surgical procedures at different surgical sites.

[0041] Slave device 150 may include a central processing unit, a memory unit, a data bus, and associated data communication ports, which are responsible for interpreting and processing signals (such as camera images) and tracking sensor data, such as from a robot manipulator. Console base 112 may include a central processing unit, a memory unit, a data bus, and associated data communication ports, which are responsible for interpreting and processing signals (such as camera images) and tracking sensor data, such as from the slave device. In some embodiments, both console base 112 and slave device 150 perform signal processing to achieve load balancing.

[0042] The console base 112 can also process commands and instructions provided by the user 120 via a control module (e.g., keyboard 116 and joystick 118). In addition... Figure 1 In addition to the keyboard 116 and joystick 118 shown, the control module may also include other devices such as a computer mouse, tracking pad, trackball, control pad, video game controller, and sensors (e.g., motion sensors or cameras) that capture hand and finger gestures.

[0043] User 120 can use master device 110 to control surgical actuator 164 coupled to slave device 150 in speed mode or position control mode. In speed mode, user 120 uses a control module to directly control the pitch and yaw movements of the surgical instrument based on direct manual control. For example, movement on joystick 118 can be mapped to yaw and pitch movements of surgical actuator 164. Joystick 118 can provide tactile feedback to user 120. For example, joystick 118 vibrates to indicate that surgical actuator 164 cannot translate or rotate further in a certain direction. Console base 112 can also provide visual feedback (e.g., pop-up messages) and / or auditory feedback (e.g., beeps) to indicate that surgical actuator 164 has reached maximum translation or rotation.

[0044] In position control mode, the console base 112 uses a three-dimensional (3D) map of the patient and a pre-defined computer model of the patient to control the slave device 150. The console base 112 provides control signals to the robotic arm 160 of the surgical robot system 100 to manipulate the surgical actuator to the surgical site 158. Because it relies on a 3D map, the position control mode requires accurate mapping of the patient's anatomy.

[0045] In some implementations, user 120 can manually manipulate the robotic arm 160 of the surgical robot system 100 without using the master unit 110. During assembly in the operating room, user 120 can move the robotic arm 160, surgical actuators 164, and other surgical instruments to enter the patient's body. The surgical robot system 100 can rely on force feedback and inertial control from user 120 to determine the appropriate configuration of the robotic arm 160 and instruments.

[0046] Display module 114 may include an electronic monitor, a virtual reality viewing device (e.g., goggles or glasses), and / or other means of displaying the device. In some embodiments, display module 114 is integrated with a control module, for example, as a tablet device with a touchscreen. Furthermore, user 120 can use the integrated display module 114 and control module to view data and input commands into the surgical robot system 100.

[0047] Display module 114 can use a stereoscopic device (e.g., a mask or goggles) to display 3D images. The 3D images provide a “surgical view,” which is a computer-generated 3D model showing the anatomical structures at the surgical site 158 on the patient. The “surgical view” provides a virtual environment inside the patient and the expected location of the surgical actuator 164 within the patient's body. User 120 compares the “surgical view” model with actual images captured by a camera to help mentally orient and confirm that the surgical actuator 164 is in the correct (or approximately correct) position within the patient's body. The “surgical view” provides information about the anatomical structures surrounding the surgical site, such as the shape of the patient's small intestine or colon. Display module 114 can simultaneously display the 3D model of the anatomical structures at the surgical site and a computed tomography (CT) scan. Furthermore, display module 114 can overlay a pre-determined optimal navigation path for the surgical actuator 164 onto the 3D model and the CT scan.

[0048] In some implementations, a model of the surgical actuator is displayed along with a 3D model to help indicate the status of the surgical procedure. For example, scans identify areas in anatomical structures that may require suturing. During operation, display module 114 may display a reference image captured by surgical actuator 164 corresponding to the current position of the surgical actuator at surgical site 158. Display module 114 may automatically display different views of the endoscope model based on user settings and specific surgical procedures. For example, display module 114 may display a top fluorescein view of the surgical end-effector as it approaches the patient's operating area during a navigation step.

[0049] II. From the robotic device

[0050] Figure 2 A slave robotic device 200 from a surgical robotic system 100 is shown according to one embodiment. The slave robotic device 200 includes a slave base 202 coupled to one or more robotic arms, such as robotic arm 204. The slave base 202 is communicatively coupled to a master device 110. The slave base 202 can be positioned such that the robotic arm 204 can enter to perform surgical procedures on a patient, while a user (such as a physician) can control the surgical robotic system 100 from the master device. In some embodiments, the slave base 202 may be coupled to a surgical operating table for patient support. Although for clarity... Figure 1 Not shown, but the base 202 may include subsystems such as control electronics, pneumatic devices, power supplies, and light sources. The robot arm 204 includes multiple arm segments 206 connected at a joint 208, providing multiple degrees of freedom. The base 202 may include a power supply 210, a pneumatic pressure device 212, and control and sensor electronics 214—including components such as a central processing unit, data bus, control circuitry, and memory—as well as associated actuators (such as motors) for moving the robot arm 204. The electronics 214 in the base 202 may also process and transmit control signals from a command console.

[0051] In some embodiments, the base 202 includes wheels 216 for transporting the slave device 150. The mobility of the slave device 150 helps accommodate spatial constraints in the operating room and facilitates the proper positioning and movement of surgical equipment. Furthermore, mobility allows the robotic arm 204 to be configured such that it does not obstruct the patient, physician, anesthesiologist, or any other equipment. During procedures, the user can control the robotic arm 204 using control devices such as the master device.

[0052] In some embodiments, the robotic arm 204 includes an assembly joint that uses a combination of brakes and a counterbalancing device to maintain the position of the robotic arm 204. The counterbalancing device may include a gas spring or a coil spring. The brake (e.g., a fail-safe brake) may include mechanical and / or electronic components. Furthermore, the robotic arm 204 may be a gravity-assisted passive support type robotic arm.

[0053] The robotic arm can be coupled to surgical instruments, such as a laparoscope 220, whereby the robotic arm positions the surgical instruments at the surgical site. The robotic arm can be coupled to the surgical instruments using a specially designed connection device 230, which allows communication between the surgical instruments and a base configured to control the surgical instruments via the robotic arm.

[0054] III. Machine and Device Operator

[0055] Figure 3 An embodiment of the end effector of a robotic arm 300 in a master / slave surgical system is shown. At the end effector of each robotic arm, a mechanism change interface (MCI) 310 can be used to attach an instrument device manipulator (IDM) 320 to the robotic arm. The MCI 310 can be a set screw or a substrate connector. The MCI 310 includes connectors for transmitting pneumatic pressure, electrical power, electrical signals, and optical signals from the robotic arm to the IDM 320.

[0056] The MCI 310 removably or permanently mounts the IDM 320 to the surgical robotic arm of the surgical robot system. The IDM is configured to attach the surgical tool connection device 230 to the robotic surgical arm in a manner that allows the surgical tool to rotate or “roll” continuously about the axis of the surgical tool (e.g., via the following). Figure 4 The support bracket and mounting bracket described in [the text]). The IDM 320 is compatible with a variety of surgical instruments ( Figure 3 (Not shown) used together, the various surgical tools may include a housing and an elongated body and can be used as end effectors for laparoscopy, endoscopy or other types of surgical instruments.

[0057] IV. Surgical Instruments

[0058] Figure 4An exemplary representation of surgical instruments in a master / slave surgical system 400 is shown. The surgical instruments are coupled to an IDM 320 via a support bracket 410 and a mounting bracket 450. The support bracket 410 and mounting bracket 450 are disc-shaped, with a cable reel 420 centrally located on the disc of the support bracket and extending outward along an operating axis 430 relative to the plane of the mounting bracket 450 perpendicular to the support bracket 410. The cable reel 420 couples a surgical actuator 440 to the support bracket 410, thereby allowing control of the surgical actuator from the base via a robotic arm and the IDM.

[0059] V. Support bracket

[0060] Figure 5 An isometric view of an embodiment of the support bracket is shown, where the mounting bracket is not shown, thus illustrating its components. The support bracket 410 includes a generally disc-shaped support base 510, wherein at least one connecting through-hole 512 engages with the outer edge of the disc to facilitate engagement of the support bracket to the mounting bracket. In some embodiments, there is no connecting through-hole for engaging the support bracket to the mounting bracket. In other embodiments, there is no direct engagement between the mounting bracket and the support bracket to the IDM. One side of the support base (hereinafter referred to as the engagement surface 514) serves as the support structure for the input controller 520, the guide pulley 530, and the reciprocating telescoping device 540. The opposite side of the support base 510 (hereinafter referred to as the operating surface 516 (not shown)) serves as the support structure for the cable reel 420.

[0061] At the center of the support base is an operating through-hole 518, which passes through the support base 510 along the operating axis 430 from the coupling surface 514 to the operating surface 516 for connecting the input controller 520 to the surgical actuator 440 via the cable reel 420. The operating through-hole 518 has a sufficiently large diameter to allow at least four cable segments 560 to pass unobstructed through the support base 510 from the coupling surface 514 to the operating surface 516.

[0062] Along the outer edge of the operating through-hole are a group of four guide pulleys 530, two outer 530a, 530d and two inner 530b, 530c, which are at least partially recessed below the plane of the connecting surface. The plane of each guide pulley 530 is orthogonal to the plane of the connecting surface 514, wherein the plane of the pulley is the plane of the pulley disc. The pulleys are positioned such that the plane of each guide pulley is perpendicular to the edge of the operating through-hole 518, wherein at least a portion of the guide pulley extends into the operating through-hole. The guide pulleys 530 are coupled to the support base 510 and configured to rotate about a central guide axis coplanar with the plane of the support base 510. In one embodiment, the guide pulleys 530 are connected to the support base 510 via bearings. The guide pulleys allow the cable 560 to move through the operating through-hole 518 without tangling or rubbing against the edge of the operating through-hole.

[0063] A ray of light emanating outward from the operating axis 430 along the plane of the guide pulley generates a group of four cable axes 550—two outer axes 550a and 550d, and two inner axes 550b and 550c. The guide pulley 530 is positioned such that the outer cable axes 550a and 550d form a line along the diameter of the support bracket, and the angle between an outer cable axis (e.g., 550a) and the nearest inner cable axis (e.g., 550b) is a non-zero angle between 0 and 90 degrees, an example of which is shown in [example missing]. Figure 5 The angle shown is approximately 60 degrees. Similarly, the angle between two internal cable axes (e.g., 550b and 550c) is between 0 and 90 degrees, with an example shown as approximately 60 degrees.

[0064] VI. Cable Reel

[0065] Cable reel 420 connects surgical actuator 440 to support bracket 410, thereby allowing control of the surgical actuator from the base via a robotic arm and IDM. In one embodiment, the cable reel is a long hollow cylinder with an actuating end connected to surgical actuator 440 and a driving end connected to the operating surface 516 of support base 510. The cable reel is connected to support base 510 such that cable reel 420 extends orthogonally from support bracket along operating axis 430. Cable reel 420 houses cable 560, which connects input controller 520 to surgical actuator 440.

[0066] VII. Input Controller

[0067] Two external input controllers 520a and 520d and two internal input controllers 520b and 520c are coupled to the support base and extend orthogonally outward from the coupling surface 514. The input controllers 520 are positioned along a concentric semi-circle around the operating axis 430, with each input controller radially equidistant from the operating axis along one of the axes of the cable axis 550. The input controllers 520 can be similarly shaped as an inverted, layered cylindrical pyramid, with cylinders of gradually increasing radius connected vertically to each other. The coupling cylinder of the input controller 520 is centrally aligned along a winding axis 556 associated with that particular input controller, which is orthogonal to the coupling surface 514 and parallel to the operating axis 430. The input controllers are positioned such that the two winding axes 556 of the external input controllers 520a and 520d form lines along the diameter of the support bracket, similar to the two external cable axes, and thus form similar angles with their nearest corresponding internal input controller relative to the operating axis 430. The two internal input controllers are similarly positioned at an angle relative to each other, much like two internal cable axes, as described above.

[0068] The support base 510 includes four circular rotary joints 570. The rotary joints 570 are configured to allow each input controller to rotate about its winding axis (such as 556). The rotary joints 570 are formed such that the top of each rotary joint is substantially flush with or slightly recessed from the engagement surface 514 of the support base 510. The rotary joints 570 are similarly positioned to the input controllers 520, wherein each input controller is coupled to the center of the rotary joint such that the axis of rotation of the rotary joint is coaxial with the winding axis 556 of the associated input controller. In one embodiment, the rotary joint is a bearing.

[0069] Although not in Figure 5 As depicted, the support bracket is further connected to the mounting bracket 450 via the input controller. The mounting bracket is connected to the input controller such that the top of the input controller passes through the mounting bracket and is substantially flush with the top of the mounting bracket. The mounting bracket is further configured with a group of similar rotary joints coaxial with the rotary joint of the support bracket, which allows the input controller to rotate. The input controller 520 and the mounting bracket 450 are configured to be connected to the IDM and to actuate the cable 560 to control the movement of the surgical actuator 440, as described in detail later. The cable 560 is connected to the input controller 520 such that the cable is at least partially wrapped around the input controller and can be wound or unwound around the controller as it rotates about its winding axis. Each input controller is connected to a single cable.

[0070] VIII. Reciprocating Expansion Joint

[0071] The reciprocating telescoper 540 is a physical structure comprising multiple physical components, so named because it is configured to move reciprocally toward the surgical actuator, discussed in sections X and XI. Therefore, the reciprocating telescoper allows the surgical instrument as a whole (particularly the wrist, and more particularly the internal cable) to maintain a constant length. The cable is tensioned using conventional techniques (such as clamping or winding around a cylinder), which tends to loosen (become less taut) over time through normal wear and tear. While cable wear may cause variations in the total cable length, these variations can be compensated for by the length-conserving system maintained by the IDM, the robotic arm, and the control computer. The reciprocating telescoper is further configured to maintain the length of the cable within the surgical instrument when not controlled by the input controller and IDM (e.g., when the surgical instrument is detached from the surgical device).

[0072] The reciprocating telescoping device has two operating modes: an attachment mode, in which the surgical instrument is attached to the IDM and the robotic arm, enabling the IDM and the robotic arm to actuate the input controller and control the movement of the surgical actuator; and a disengagement mode, in which the surgical instrument is disengaged from the IDM and the robotic arm, allowing the reciprocating telescoping device and the input controller to passively maintain the length of the surgical cable of the surgical actuator, thereby preventing it from loosening / falling off.

[0073] VIII-A. Construction of Reciprocating Expansion Joint

[0074] The reciprocating telescoping element 540 is connected to the support base 510 on one half of the connecting surface 514 opposite to the internal input controllers 520b and 520c. Figures 6A to 6C The reciprocating telescoping device 540, as shown in the unfolded diagram, includes two connected differentials, a rotating shaft, and an armature. The rotating shaft extends orthogonally outward from the coupling surface 514, with its central axis (hereinafter referred to as the reciprocating axis 558) parallel to the operating axis 430. The rotating shaft is positioned radially away from the operating axis 430. Furthermore, the angle between the outer winding axis 556, the operating axis 430, and the reciprocating axis 558 is approximately 90 degrees, but in other embodiments, it can be a different angle.

[0075] Figure 6A This is an isometric view of an exemplary reciprocating telescoping device 540. The reciprocating telescoping device includes an armature 620 that connects two differentials 610a and 610b. A first differential 610a connects a pair of pulleys: a first pulley is a reciprocating wrist pulley 612a with two grooves, and a second pulley is a reciprocating component pulley 614a with one groove. A second differential 610b is similarly configured with a wrist pulley 612b and a component pulley 614b. In another embodiment, the reciprocating wrist pulleys 612a and 612b may comprise two separate coaxial single-groove pulleys or a single pulley with a single groove large enough to allow for two cables. The armature 620 connects the differentials 610a and 610b to each other such that the reciprocating wrist pulleys 612a and 612b are coaxial with each other and with the reciprocating axis 558. Additionally, armature 620 connects the reciprocating component pulleys 614a and 614b of each differential to a distance equidistant from the reciprocating wrist pulleys 612a and 612b. Armature 620 further connects the reciprocating component pulleys 614a and 614b such that they are positioned about a non-zero angle apart from each other about the reciprocating axis 558. In other embodiments, reciprocating component pulleys 612 and 614 are at different distances. Reciprocating component pulleys 614 rotate about a tension axis 630, which forms an acute angle with the reciprocating axis 558.

[0076] VIII-B. Reciprocating Expansion Joint Wiring

[0077] Within each differential 610, the reciprocating wrist pulley 612 and the reciprocating component pulley 614 are further connected by a cable 560. For discussion purposes, the cable can be described as having an entry section 616a and an exit section 616b, wherein the entry section extends from the reciprocating axis 558 toward the tension axis 630 and the exit section extends from the tension axis toward the reciprocating axis. The section definitions are arbitrary as the cable moves during use, and for clarity, are defined here relative to the pulleys, rather than at fixed positions on the cable itself.

[0078] In the entry section 616a, the cable is at least partially wound around the reciprocating wrist pulley 612 in a first groove. The cable then at least partially wound around the reciprocating component pulley 614, thereby connecting the reciprocating component pulley to the reciprocating wrist pulley 612, transitioning to the exit section. In the exit section 616b, the cable then further at least partially wound around the reciprocating component pulley 614, thereby reversing the direction of the cable, after which the cable is guided away from the tension axis 630. The exit section of the cable is at least partially wound around a second groove of the reciprocating component wrist pulley 612, after which the cable is guided away from the reciprocating axis 558.

[0079] VIII-C. Reciprocating Expansion Joint Movement

[0080] Figure 6B An example of how input controllers are coupled to a constraint expansion joint is shown. The top layer of each input controller 520 (i.e., the cylinder furthest from the coupling surface of the support bracket) is configured to removably attach the input controller to a corresponding actuator of the IDM, such that the IDM can manipulate the rotation of the input controller about its independent winding axes 556a, 556b, 556c, 556d. Additionally, each pair of input controllers 520 is coupled via cable 560 to one of the differentials 610 of the reciprocating expansion joint 540, such that the inlet and outlet sections of the cable connect the first input controller to the second input controller in the input controller pair. In the illustrated embodiment, the external input controller 520a and the internal input controller 520b are paired by a first cable, and the internal input controller 520c and the external input controller 520d are paired by a second cable; however, those skilled in the art will recognize that any two input controllers can be paired together.

[0081] When the laparoscopic instrument is attached to the IDM to perform procedures at the surgical site, the reciprocating telescoping mechanism is in attachment mode. In attachment mode, the differential of the reciprocating telescoping mechanism maintains a constant length for each cable in the cables connecting each pair of input controllers. The total length of the cables is manipulated by the interaction of winding and unwinding the pair of input controllers associated with a given cable, and by constraining the rotation of the telescoping mechanism about the reciprocating axis. To maintain the cable length, pulleys in the differential and armature rotate about the reciprocating and extension axes to produce equal and opposite extensions (or shortenings) to compensate for the shortening (or extension) produced by winding or unwinding the input controllers about their winding axes.

[0082] Figure 6B and Figure 6C The process is illustrated, and the following paragraphs further detail the interactions between the inbound and outbound cable segments, the reciprocating telescoping mechanism, and the input controller pair. For clarity, in the following text, the inbound segment of the first cable within the first differential is segment 660a, the outbound segment of the first cable within the first differential is segment 660b, the inbound segment of the second cable within the second differential is segment 660c, and the outbound segment of the second cable within the second differential is segment 660d.

[0083] Additionally, the first input controller in the first controller pair controls the length of the first segment 660a; the second input controller in the first controller pair controls the length of the second segment 660b; the first input controller in the second controller pair controls the length of the third segment 660c; and the second input controller in the second controller pair controls the length of the fourth segment 660d. Any pair of cable segments described above can be described as an inbound / outbound segment pair, depending on the winding / unwinding performed on one of the input controllers of that pair at that moment. In the illustrated embodiment, the internal input controller and the external input controller (e.g., 520a and 520b) are paired; however, those skilled in the art will understand that the input controllers can be configured in different pairs.

[0084] In the illustrated implementation, for a given cable of the input controller pair connected via a differential, there are five possible states in the additional mode. In the first state, the input controller pair simultaneously decreases the length of the first segment and increases the length of the second segment. In the second state, the input controller pair simultaneously increases the length of the second segment and decreases the length of the first segment. In the third state, the input controller pair simultaneously unwinds the first and second segments, causing the reciprocating telescoping mechanism to rotate compensatingly about the reciprocating axis to conserve the cable length. In the fourth state, the input controller pair simultaneously winds the first and second segments, causing the reciprocating telescoping mechanism to rotate compensatingly about the reciprocating axis to conserve the cable length. In the fifth "neutral" state, the input controller pair does not manipulate the cable segments. In all possible states, the cable length from the first input controller to the second controller in the input controller pair is conserved.

[0085] Figure 6B This is a plan view of the support bracket, showing the input controller and reciprocating telescoping mechanism in a first state for the cables associated with the first segment 660a and the second segment 660b. The first input controller 520a unwinds the cable, thereby increasing the length 670a of the first segment 660a (shown as an arrow), while the second input controller 520b winds the same cable, thereby decreasing the length 670b of the second segment 660b. This causes the reciprocating member pulley 614 to rotate about the extension axis 630, the reciprocating wrist pulley 612 not to rotate about the reciprocating axis 558, the armature 620 not to rotate about the reciprocating axis 558, and the cable to reciprocate within the operating through-hole 518. In this embodiment of the first state, the contact area 640a of the cable in contact with the reciprocating wrist pulley remains unchanged. The second state is similar to the first state, wherein the first and second input controllers are reversed.

[0086] Figure 6CThis is a plan view of the support bracket, showing the input controller and reciprocating telescoping device in a third stretched state. The first input controller in the input controller pair (e.g., external input controller 520a) is wound around its winding axis 556a (attempting to reduce the length 680a of the first segment 660a), while the second input controller in the input controller pair (e.g., internal input controller 520b) is wound around its winding axis 556b (attempting to reduce the length 680a of the third segment 660b). This causes the reciprocating component pulley 614 to rotate about the stretch axis 630, the reciprocating wrist pulley to rotate about the reciprocating axis 558, and the differential to rotate about the reciprocating axis 558. In this embodiment of the third state, the differential rotates 690 about the reciprocating axis 558, the amount of rotation compensating for the cable segment wound around the input controller pair, such that the contact area 640b between the cable and the reciprocating wrist pulley is reduced, and the total length of the cable in the telescoping device is maintained. The fourth state is similar to the third state, in which the first input controller and the second input controller simultaneously unwind the first segment and the second segment, wherein the unwinding is counteracted by the rotation of the differential about the reciprocating axis.

[0087] IX. Surgical Actuator

[0088] Figure 7A An embodiment of a surgical actuator for laparoscopic examination in a master / slave surgical system is shown. The surgical actuator includes two working members 710, a surgical wrist 720, and an actuator housing 730a. Figure 7B This is an illustration of a surgical actuator with the actuator housing removed.

[0089] IX-A. Surgical Actuator Construction

[0090] The two working components 710 can be designed as robotic versions of existing surgical tools for performing surgical procedures, for example, Figure 7A and Figure 7B The illustrated small robotic tweezers. Each working component includes a component pulley 712 with a single groove and a tweezer half 714. The component pulley has an outer surface and an inner surface and is rotatable about a centrally located axis of rotation (hereinafter referred to as component axis 740) orthogonal to the inner and outer surfaces. The component pulley may have a centrally located component hole 716, which is coaxial with the component axis passing from the inner surface to the outer surface and orthogonal to the operating axis 430.

[0091] Each forceps half 714 has a substantially flat side and a rounded side, the flat side being used for interaction with tissue during surgical procedures. The substantially flat side may be textured to allow for easier interaction with tissue during surgical procedures. In another embodiment, the forceps are configured to interact with a needle during surgical procedures. Each forceps half 714 is independently coupled to a component pulley 712 such that the forceps half is perpendicular to the edge of the component pulley and extends radially away from the component axis 740 in the plane of the component pulley 712. The component pulley 712 is further coupled to the forceps half 714 such that the forceps half also rotates about the component axis 740.

[0092] The working member 710 is connected such that the inner surface of the member pulley is substantially flush with the coaxial member hole 716 and member axis 740. The working member 710 is further connected such that the flat sides of each tweezer half face each other and can be coplanar.

[0093] The surgical wrist 720 comprises a group of two wrist pulleys 722, 724, each having four grooves. The first wrist pulley 722 may have a larger radius than the second wrist pulley 724. Each wrist pulley has a front and a back side and is rotatable about a centrally located axis of rotation (hereinafter referred to as wrist axis 742) orthogonal to both the front and back sides. In this document, the four grooves of the wrist pulley are referred to sequentially from back side to front side as one through four. The wrist pulleys 722, 724 may have a centrally located wrist hole 726 coaxial with the wrist axis 742 passing through the wrist pulley from front side to back side. The wrist axes 742 of each wrist pulley are parallel to each other, orthogonal to the component axis 740, and orthogonal to the operating axis 430, such that the three types of axes form an orthogonal set 744. The wrist pulleys are positioned such that all front faces are coplanar, wherein the first wrist pulley 722 is closer to the actuating end of the cable shaft 420 along the operating axis 430 than the second wrist pulley 724.

[0094] The actuator housing 730a may be a cylindrical protective metal sleeve that connects the wrist pulleys 722, 724 to the component pulley 712 while allowing the cable 560 to move through the sleeve. In some embodiments, the actuator housing may include a proximal U-clamp 730b and a distal U-clamp 730c, the proximal U-clamp 730b being connected to the distal U-clamp 730c by a connecting pin. The first wrist pulley 722 and the second wrist pulley 724 are connected to the actuator housing 730a by separate retaining screws 732 that pass through wrist holes 726 in the wrist pulleys 722, 724 along a wrist axis 742 from one side of the housing to the other. The component pulley 712 is connected to the actuator housing by a single retaining screw 734 that passes through a central component hole 716 in the component pulley 712 along a coaxial component axis 740 from one side of the housing to the other. The component pulley 712 is further connected to the actuator housing, wherein the tweezers half 714 extends along the operating axis 430 toward the movable end of the cable shaft 420 away from the actuator housing. The housing connects the wrist pulleys 722, 724 and the component pulley 712 such that the component pulley is closer to the movable end of the cable shaft 420 along the operating axis 430 than the wrist pulley. The actuator housing 730a connects the wrist pulleys 722, 724 and the component pulley 712 to maintain an orthogonal set of the operating axis 430, the component axis 740 and the parallel wrist axis 742, that is, the outer surface of the component pulley 712, the front surfaces of the wrist pulleys 722, 724 and the operating axis 430 are orthogonal 744.

[0095] IX-B. Surgical Actuator Wiring

[0096] Within the housing, the wrist pulleys 722, 724 and the component pulley 712 are further connected by two cables. In some embodiments, the cables within the actuator housing are different from the two cables connecting the input controller to the reciprocating telescoping mechanism; for clarity, they will be referred to hereinafter as the third and fourth cables. For discussion purposes, the cables can be described as having an inlet section and an outlet section, wherein the inlet section extends from the drive end within the cable spool to the actuating end and the outlet section extends from the actuating end within the cable spool to the drive end.

[0097] In the following text, the entry segment of the third cable is the fifth segment 750a, and the exit segment of the third cable is the sixth segment 750b. According to one possible wiring scheme, the entry segment 650a of the cable at least partially surrounds the second wrist pulley in a first groove. Then, the fifth segment 750a at least partially surrounds the first groove of the first wrist pulley 722 within the housing, thereby connecting the first wrist pulley to the second wrist pulley. Then, the entry segment at least partially surrounds the first groove of the first component pulley 712, thereby connecting the first wrist pulley to the component pulley. The entry segment 750a, at least partially surrounding the first component pulley 712, reverses the direction of the cable away from the operating end and begins the exit segment 650b. On the exit segment 650b, the cable at least partially surrounds the third groove of the first wrist pulley 722. Then, the exit segment 650b at least partially surrounds the third groove of the second wrist pulley 724.

[0098] Similarly, the entry segment of the fourth cable is the seventh segment 750c, and the exit segment of the fourth cable is the eighth segment 750d. Continuing with the same wiring scheme as above, the entry segment 750a at least partially surrounds the second groove of the wrist pulleys 722 and 724 on the entry route, at least partially surrounds the second member pulley 712, thereby reversing the direction to begin the exit segment 750d, and at least partially surrounds the fourth groove of the wrist pulley.

[0099] In the illustrated embodiment, the inbound cable at least partially wraps around one half of the second wrist pulley and the opposite half of the first wrist pulley. It will be apparent to those skilled in the art that these halves can be reversed.

[0100] In the illustrated embodiment, the third cable at least partially wraps around the wrist pulley in the first groove on the inbound route and the third groove on the outbound route, while the fourth cable at least partially wraps around the wrist pulley in the second groove on the inbound route and the fourth groove on the outbound route. It will be apparent to those skilled in the art that the grooves on the inbound and outbound routes can be configured differently for the third and fourth cables.

[0101] Figure 8 The diagram illustrates how the input controller 520 is coupled to the surgical actuator 440. The bottom layer of each input controller 520 is coupled to a rotary joint 570 on the support bracket 410. Each pair of internal and external input controllers (e.g., 520a and 520b) is coupled to the surgical actuator 440 via a cable passing through an operating through-hole 518, such that the fifth inlet segment 750a of the external input controller is coupled via the surgical actuator 440 to the sixth outlet segment 750b of the internal input controller. In an alternative configuration, the inlet and outlet segments and the paired input controllers are interchangeable.

[0102] IX-C Surgical Actuator Degrees of Freedom

[0103] In the described configuration, the surgical actuator has three controllable degrees of freedom: Figures 9A to 9D The first yaw angle 910, the second yaw angle 920, and the pitch angle 930 are shown in the figure.

[0104] like Figure 9A and Figure 9B As shown, the first degree of freedom is the movement of the first tweezer half 714 when the first component pulley 712 rotates 912 around the component axis 740 (i.e., the yaw axis), thereby causing the tweezer half 714 to move in the plane of the first component pulley, so that the tweezer half generates a first yaw angle 910 with respect to the operating axis 430.

[0105] Similarly, the second degree of freedom is the movement of the second tweezer half 714 when the second component pulley 712 rotates about the component axis 740 (i.e., the yaw axis), thereby causing the second tweezer half to move in the plane of the second component pulley, so that the tweezer half produces a second yaw angle 920 with respect to the operating axis 430.

[0106] like Figure 9C and Figure 9D As shown, the third degree of freedom is the movement of the working component when the first wrist pulley 722 rotates around the first wrist axis 742 (i.e., the pitch axis), thereby causing the working component to move in the plane of the first wrist pulley 722, so that the working component produces a pitch angle 930 with respect to the operating axis 430.

[0107] In the described embodiment, the first yaw angle and the second yaw angle are coplanar, and the plane of the pitch angle is orthogonal to the plane of the yaw angle. In other embodiments, the first yaw angle, the second yaw angle, and the pitch angle may have different orientations relative to the operating axis. In still other embodiments, the first yaw angle and the second yaw angle may not be coplanar.

[0108] The surgical actuator also has two additional degrees of freedom of movement: rotational angle and translational distance. The rotational angle is generated by the rotation of the IDM and MCI around the operating axis. The translational distance is generated by the movement of the robotic arm, causing the cable shaft to translate along the operating axis.

[0109] IX. Surgical actuator movement

[0110] In this system, movement in three degrees of freedom is generated by the rotation of component pulley 712 and wrist pulleys 722 and 724 around their respective axes. The rotation of the pulleys around their axes is caused by the input controller winding or unwinding the cable to control the length of the cable.

[0111] Figures 9A to 9D A method for inducing movement of a surgical actuator in three controllable degrees of freedom by controlling the length of the cables is further illustrated. In this embodiment, each input controller is coupled to an input or output segment of a third cable or a fourth cable in the surgical actuator. The first input controller in the first controller pair controls the length of the fifth segment 750a; the second input controller in the first controller pair controls the length of the sixth segment 750b; the first input controller in the second controller pair controls the length of the seventh segment 750c; and the second input controller in the second controller pair controls the length of the eighth segment 750d.

[0112] Figure 9A A surgical actuator in an exemplary "neutral" state is shown, where the first yaw angle 910, the second yaw angle 920, and the pitch angle 930 are not offset from the operating axis 430, and no cable segment length is modified. The first yaw angle 910 is manipulated by controlling the length of the fourth cable, such that the length of the seventh segment increases 921 while the length of the eighth segment decreases 922. This configuration moves the fourth cable, which in turn rotates the first component pulley about the component (yaw) axis 740, increasing the first yaw angle 910 between the forceps half 714 and the operating axis 430. In a reciprocating configuration, the first yaw angle 910 can be decreased by decreasing the length of the seventh segment and increasing the length of the eighth segment. In both configurations, the total length of the surgical cable is maintained.

[0113] Similarly, the second yaw angle is manipulated by controlling the length of the third cable, causing the length of the fifth segment 750a to increase and the length of the sixth segment 750b to decrease. This configuration moves the fourth cable, which in turn rotates the second component pulley about the component axis 740, increasing the second yaw angle 920 between the forceps half and the operating axis 430. In the reciprocating configuration, the third cable moves such that the yaw angle can be reduced by increasing the length of the eighth segment and decreasing the length of the seventh segment. Furthermore, the movement of the forceps half about the yaw axis can be in any direction away from the operating axis in the plane of the component pulley. In both configurations, the total length of the surgical cable is maintained.

[0114] In some implementations, manipulation of the cable segment length introduces additional "degrees of freedom," such as grip strength. In these implementations, movement with respect to the first and second degrees of freedom may be mutually restrictive; that is, one tweezer half may be unable to change its yaw angle 910 due to the position and yaw angle 920 of the other tweezer half. This could occur, for example, due to an object being held between the tweezer halves. The amount of electrical load measured in the system when the first and second degrees of freedom are mutually restrictive provides a measure of grip strength.

[0115] Figure 9CThe surgical actuator is shown in a neutral state, i.e., the first yaw angle 910, the second yaw angle 920, and the pitch angle 930 are not offset from the operating axis 430, and no cable segment is manipulated by the input controller. The pitch angle 930 is manipulated by controlling the lengths of the third and fourth cables. The lengths of the fifth and sixth segments are increased by 924, while the lengths of the seventh and eighth segments are decreased by 926, thereby causing the first wrist pulley to rotate 914 about the pitch axis. This configuration causes the third and fourth cables to move, which increases the pitch angle between the working member 710 and the operating axis 430 in the plane of the first wrist pulley 722. The rotation of the actuator about the pitch angle compensates for the increase and decrease in the segment lengths, such that the lengths of the first and second cables are conserved. In a reciprocating configuration, the pitch angle can be decreased by decreasing the lengths of the fifth and sixth segments while increasing the lengths of the seventh and eighth segments. In all configurations, the length of the surgical cables is conserved. In addition, the movement of the working component around the pitch axis can be in any direction away from the operating axis in the plane of the wrist pulley.

[0116] The above description describes a configuration of controlled degrees of freedom in which each movement is asynchronous and independently controlled; for example, first opening one half of a forceps and then tilting the wrist, etc. However, in most robotic surgical procedures, the degrees of freedom are changed simultaneously; for example, opening the forceps while simultaneously rotating its orientation at the surgical site. Those skilled in the art will note that simultaneous movement of three controllable degrees of freedom is achieved through a more complex control scheme that uses the winding and unwinding input controller to control four cables and segment lengths.

[0117] In one embodiment, the control scheme is a computer program running on the control base of a master device configured to interpret the user's movements as corresponding actions of a surgical actuator at the surgical site. The computer program may be configured to measure the rotation of the input controllers to calculate the length of the cable segment and / or the electrical load required for movement. The computer program may be further configured to compensate for variations in cable elasticity (e.g., if the cable is a polymer) by increasing / decreasing the amount of rotation required to change the length of the cable segment by the input controllers. Tension can be adjusted by coordinating the increase or decrease of the rotation of all input controllers. Tension can be increased by simultaneously increasing rotation and decreased by simultaneously decreasing rotation. The computer program may also be configured to maintain a minimum tension level in the cable. If the tension of any cable in the cable is sensed to drop below the lower limit of the minimum tension threshold, the computer program may coordinatingly increase the rotation of all input controllers until the cable tension in all cables is above the lower limit of the minimum tension threshold. If the tension of all cables in the cable is sensed to rise above the upper limit of the minimum tension threshold, the computer program may coordinatingly decrease the rotation of all input controllers until the cable tension in any cable is below the upper limit of the minimum tension threshold. The computer program can also be configured to identify the operator's grip strength based on the load of a motor actuated to an input controller connected to a cable segment, particularly when the working component is held on or pressed against an object. More generally, the computer program can be further configured to control the translation and rotation of surgical instruments via a robotic arm and an IDM.

[0118] X. Reciprocating motion

[0119] The reciprocating telescoping mechanism is configured to simulate the movement of a surgical actuator in a reciprocating manner. Figures 10A to 10C An example of reciprocating motion in a surgical instrument is shown.

[0120] Figure 10A An example wiring diagram of a laparoscopic device in a neutral state is shown. The external input controller 520a and internal input controller 520b of the first input controller pair are connected by a first cable and a third cable, controlling the winding and unwinding of the cable segments. The first cable connects the input controller pair within the reciprocating telescoping unit 540 via a first cable segment 660a and a second cable segment 660b. The third cable connects the input controller pair within the surgical actuator 440 via a fifth segment 750a and a sixth segment 750b. The lengths of the first and second cable segments are controlled by rotating the external input controller 520a and the internal input controller 520b about their winding axes 556a and 556b, respectively. This rotation simultaneously changes the lengths of the fifth and sixth cable segments in a reciprocating manner; for example, increasing the length of the first segment 750 decreases the length of the fifth segment 662, thus conserving the total cable length between the input controllers.

[0121] The internal and external input controllers in the second input controller pair are connected by a second and a fourth cable, and control the winding and unwinding of the cable segments. The internal input controller 520c and external input controller 520d in the first input controller pair are connected by a second and a fourth cable, and control the segment lengths. The second cable connects to the input controller pair within the reciprocating telescoping actuator 540 via a third cable segment 660c and a fourth cable segment 660d. The fourth cable connects to the input controller pair within the surgical actuator 440 via a seventh segment 750c and an eighth segment 750d. The lengths of the third and fourth cable segments are controlled by rotating the internal input controller 520c and the external input controller 520d about their respective winding axes 524c and 524d. This rotation simultaneously changes the lengths of the seventh and eighth cable segments in a reciprocating manner; for example, increasing the length of the third segment decreases the length of the seventh segment.

[0122] Figure 10B An embodiment in which the first yaw angle 910 of the surgical actuator 440 is increased is first shown. The yaw angle is controlled by winding and unwinding the first input controller pair (520a and 520b), such that the length of the fifth segment decreases by 1000° while the length of the sixth segment increases by 1002°. As the yaw angle increases, the length of the first segment increases by 1004° while the length of the second segment decreases by 1006°, such that within the constraint telescoping mechanism, the component pulley rotates about the tension axis. In this configuration, the total length of the third cable is maintained within the reciprocating telescoping mechanism 540, and the length of the first cable is maintained within the surgical actuator and cable shaft. The second yaw angle can be manipulated by similarly winding the second pair of input controllers to manipulate the segment lengths of the third and fourth cables. Either yaw angle can be reduced by manipulating the segment lengths in reverse using the input controllers.

[0123] Figure 10C An embodiment of increasing the pitch angle 930 of the surgical actuator 440 is shown. The pitch angle of the surgical actuator is controlled by unwinding the first cable, thereby attempting to increase the lengths of the fifth segment 1010 and the sixth segment 1012, while simultaneously winding the second cable, thereby attempting to decrease the lengths of the seventh segment 1020 and the eighth segment 1022. The change in pitch angle in the surgical actuator compensates for the winding and unwinding of the cables, such that the lengths of the first and second cables are conserved. As the pitch angle 930 increases, the lengths of the first segment 1014 and the second segment 1016 increase, while the lengths of the third segment 1024 and the fourth segment 1026 decrease, causing the wrist pulley and armature to rotate about the reciprocating axis 1030 within the restraint telescopic mechanism. In this configuration, as previously discussed, the total length of the third cable is maintained within the reciprocating telescopic mechanism. The pitch angle can be reduced by manipulating the segment lengths of the cables in a reverse manner using an input controller.

[0124] XI. Separation Mode

[0125] When performing surgical procedures at the surgical site, the reciprocating telescoping actuator and the input controller operate in attached mode, and the input controller manipulates the degrees of freedom of the surgical actuator.

[0126] The input controller and reciprocating telescoper can also operate in a disengaged mode, where the input controller is configured to maintain the length of the cable in the restraint telescoper. This is useful when attaching or detaching surgical instruments from the IDM and robotic arm. To remove surgical instruments from the IDM and robotic arm, the cable can be manipulated to achieve a specific length, which will be maintained for the period between uses of the surgical instruments.

[0127] In another embodiment, during the separation mode, the lengths of the first to fourth cables are controlled by actuation of a mechanism other than the input controller to achieve the desired result; for example, this mechanism may be a switch, button, lever, pin, or the like. In some embodiments, actuation of this alternative mechanism may release any held object from the actuator; move the cable position toward a neutral position; or move the actuator to a neutral position for removal, etc.

[0128] XII. Manual Actuator

[0129] Figure 12A and Figure 12B An example of a manual actuator 1210 is shown, which can be included in a surgical instrument to provide a mechanism for actuation in addition to an input controller. Figure 12A The manual actuator 1210 is shown in a first actuation position corresponding to the first actuation state 1260, and... Figure 12B A manual actuator 1210 is shown in a second actuation position corresponding to a second actuation state 1270. The manual actuator 1210 can be configured to control the degrees of freedom of an actuator of a surgical instrument by operating a telescoping mechanism 540. For example, the manual actuator 1210 can be configured to open and close the wrist in a disengaged or disengaged robot mode by rotating the telescoping mechanism 540 about a reciprocating axis 558, such that, for example, a first actuation state 1260 and a first actuation position of the manual actuator 1210 correspond to an actuation state with the wrist closed, and a second actuation state 1270 and a second actuation position correspond to an actuation state with the wrist open.

[0130] Figure 12A and Figure 12BA manual actuator 1210 with an engagement interface 1212 is shown, which is configured to engage with a corresponding engagement interface 1242 of a telescopic member 540. The engagement interface 1212 of the manual actuator 1210 includes gear teeth on an inner surface of the manual actuator 1210, and the corresponding engagement interface 1242 of the telescopic member 540 includes gear teeth on an outer surface of the telescopic member, which are configured to mesh with (i.e., complement) the gear teeth of the manual actuator. The gear teeth on the inner surface of the manual actuator 1210 correspond to an operating axis 430 or longitudinal axis facing the cable reel 420. Figure 5 The radial inner surface of the telescoping device 540, and the gear on the outer surface of the telescoping device 540, corresponds to the operating axis 430 or the longitudinal axis opposite to the cable shaft 420. Figure 5 The radial outer surface of ).

[0131] The manual actuator 1210 further includes a user-operable portion 1214, which can be operated by a user from outside the surgical instrument, such that the manual actuator 1210 and therefore the telescopic device 540 can be manually operated by the user's hand. Figure 12A and Figure 12B In the example shown, the user-operable portion 1214 is configured as a tab that projects radially outward from the surgical instrument and is operable from outside the instrument. Movement of the user-operable portion 1214 causes a manual actuator to slide relative to the support base 510 in a circumferential or lateral direction, and causes the manual actuator to rotate the telescopic member 540 relative to the support base 510 about a reciprocating axis 558 via engagement between the gear teeth of corresponding engagement interfaces 1212, 1242. The manual actuator 1210 can be configured to slide or otherwise move between a first actuation position corresponding to a first actuation state 1260 and a second actuation state 1270.

[0132] Despite Figure 12A and Figure 12B The diagram shows a direct engagement or gear meshing between the manual actuator 1210 and the telescopic device 540. However, it is contemplated that in some embodiments, one or more intermediate mechanical couplings or gears may be provided at the connection between the manual actuator and the telescopic device to, for example, scale wrist actuation to be more precise or more direct as required by the specific design of the device.

[0133] Figure 13 A cover 1330 (or housing) is shown, configured to accommodate the telescopic device 540 and other internal mechanisms of surgical instruments. The cover 1330 includes an opening 1350 to allow access to the user-operable portion 1214. These components are also... Figure 12A and Figure 12B The symbols and tags are shown in the text.

[0134] As shown, the user-operable portion 1214 can be configured as a tab protruding outward through the cover 1330, and the opening 1350 can be configured as a circumferential slot in the cover 1330. A manual actuator can be slidably mounted or supported by the cover 1330, allowing the tab to move or slide along the cover. The opening 1350 allows the manual actuator to be operated from outside the surgical instrument, while the manual actuator is mechanically coupled to a telescoping mechanism 540 inside the instrument via the opening 1350 of the cover 1330. The tab can be manipulated by the user to slide along the slot and move between a first actuated position and a second actuated position (and optionally one or more positions in between). Thus, the cover 1330 protects the internal mechanisms of the instrument while allowing manual operation of internal mechanisms, such as the telescoping mechanism 540.

[0135] According to some embodiments, the cover 1330 can be configured to move relative to other parts of the surgical instrument. Such an arrangement can be used, for example, to facilitate a latching or mechanical connection between the surgical instrument and the robotic system in a manner that creates a secure connection or seal.

[0136] Figure 14A and Figure 14B An example is shown where the cover 1330 is configured to move relative to the support base 510. Figure 14A The cover 1330 is shown in a first position, in which the cover is generally aligned with the support base 510 and positioned lower relative to the orientation of the figure. Figure 14B The cover 1330 is shown in a second position, in which the cover is offset from the support base 510 and positioned in a higher position relative to the orientation of the figure. Figure 14A This can correspond to a first position of the surgical instrument, in which the surgical instrument is detached or removed from the robotic system. Figure 14B This can correspond to the second position of the surgical instrument during the installation or removal of the surgical instrument from the robotic system. Figure 14A and Figure 14B It can also correspond to the cover 1330 along the operating axis 430 or the longitudinal axis relative to the shaft 420. Figure 5 Different longitudinal positions of the movable cover. Although specific examples are shown and described, other configurations and geometries of the movable cover are also envisioned.

[0137] When the cover 1330 moves to different positions, the manual actuator mechanism is configured to maintain the mechanical engagement between the manual actuator 1210 and the telescopic member 540. For example, the height of the engagement interface 1212 of the manual actuator 1210, the height of the corresponding engagement interface 1242 of the telescopic member 540, or combinations thereof, can be configured to allow the manual actuator 1210 to move in a direction perpendicular to the plane defined by the support base 510 or along the longitudinal axis of the shaft 420. Figure 5 The telescoping mechanism moves in the direction of the cover 1330 without having to actuate the telescoping mechanism 540 during such movement and simultaneously maintain mechanical engagement with the telescoping mechanism. In the example shown, the gear teeth of either or both of the engagement interfaces 1212, 1242 have a sufficiently long tooth width to allow the teeth to remain engaged with the cover in a direction along the width of the teeth and transverse to the actuation direction along the slot.

[0138] XIII. Alternative Implementation Plan

[0139] In an alternative implementation of the attachment mode operation, similar to Figures 6A to 6C By configuration, the constraint telescoping mechanism can physically rotate about its reciprocating axis, allowing manipulation of one degree of freedom of the surgical actuator. The manipulated degree of freedom depends on how the input controller pairs are connected.

[0140] Figure 11 A surgical actuator is shown with cable segments 5 through 8 labeled 750a-750d. The input controllers are connected to the surgical actuators in two pairs via a differential. Using the four cable segments, there are three different pairing possibilities for the two cables in the surgical actuator: (1) the fifth and sixth segments are paired with the first input controller pair, and the seventh and eighth segments are paired with the second input controller pair; (2) the fifth and seventh segments are paired with the first input controller pair, and the sixth and eighth segments are paired with the second input controller pair; and (3) the fifth and eighth segments are paired with the first input controller pair, and the sixth and seventh segments are paired with the second input controller pair.

[0141] The surgical instrument is configured such that rotation of the reciprocating telescope winds and unwinds a cable segment, thereby pairing one input controller pair while simultaneously winding and unwinding another input controller pair. Using this configuration, rotation of the reciprocating telescope results in three different surgical actuator movements depending on the input controller pairings: a first possible pairing results in manipulation of the pitch angle, a second possible pairing results in simultaneous manipulation of two yaw angles in the same direction, and a third possible pairing results in simultaneous manipulation of two yaw angles in opposite directions.

[0142] These pairings can be incorporated into tools for potential mechanical overrun of surgical instruments in specific situations (e.g., emergency release, power outage, etc.). For example, a third pairing allows an emergency command to automatically release a held object from the surgical actuator, thus enabling faster removal of surgical instruments in emergency situations.

[0143] XIII. Additional Considerations

[0144] This disclosure also includes the following features and specific implementations, which are described in the following terms.

[0145] Clause 1. A surgical instrument comprising:

[0146] A surgical actuator having at least N degrees of freedom, the surgical actuator being used to manipulate an object at a surgical site;

[0147] At least N+1 independently operable input controllers are configured to control the surgical actuator;

[0148] The telescopic joint includes at least one differential; and

[0149] Multiple cables, the multiple cables being configured such that actuation of the input controller manipulates the cables, the cables being further configured such that:

[0150] At least one cable connects at least one input controller to the surgical actuator, such that manipulation of the at least one cable using the at least one input controller causes the surgical actuator to move.

[0151] At least one cable connects the telescopic unit to at least one input controller in the input controller, such that manipulation of the at least one cable using the at least one input controller causes the telescopic unit to move.

[0152] Clause 2. The surgical instrument according to Clause 1, wherein the at least N degrees of freedom include a combination of at least one of pitch, yaw, and grip.

[0153] Clause 3. The surgical instrument according to Clause 1, wherein the input controller is further configured such that actuation of the input controller causes the input controller to rotate about a rotation axis, and the rotation of the input controller causes the cable to be wound or unwound around the input controller.

[0154] Clause 4. The surgical instrument according to Clause 3, wherein actuation of the input controller causes the movement of the surgical actuator to induce reciprocating motion in the telescoping mechanism.

[0155] Clause 5. The surgical instrument according to Clause 3, wherein the telescoping device is further configured such that movement of the cable causes a counter-movement of the telescoping device.

[0156] Clause 6. The surgical instrument according to Clause 1, wherein actuation of the input controller does not change the length of the cable.

[0157] Clause 7. The surgical instrument according to Clause 1 further includes a cable reel that decouples the surgical actuator from the at least N+1 input controllers along an operating axis.

[0158] Clause 8. The surgical instrument according to Clause 7 further includes a support bracket for mounting the input controller, the telescopic device, and the cable reel.

[0159] Clause 9. The surgical instrument according to Clause 8 further includes a manipulator, wherein the manipulator includes at least N+1 motors for controlling the at least N+1 input controllers.

[0160] Clause 10. The surgical instrument according to Clause 9, wherein the telescoping device is configured to maintain the state of the cable when the support bracket is not attached to the manipulator.

[0161] Clause 11. The surgical instrument according to Clause 9, wherein the support bracket is removably attached to the manipulator.

[0162] Clause 12. A surgical wrist that moves with at least N degrees of freedom, wherein at least one of N+1 surgical cables is connected to each of at least N+1 independently operable input controllers, telescopic devices, and the surgical wrist, wherein the independently operable input controllers are configured to control the movement of the wrist when actuated such that an anti-movement occurs in the telescopic device to conserve the length of the surgical cables.

[0163] Clause 13. The surgical wrist as described in Clause 12, wherein the at least N degrees of freedom include a combination of at least one of pitch, yaw, and grip.

[0164] Clause 14. The surgical wrist as described in Clause 12, wherein actuation of the input controller causes the input controller to rotate about a rotation axis, and the rotation of the input controller causes the surgical cable to wrap around or unwrap around the input controller.

[0165] Clause 15. The surgical wrist as described in Clause 14, wherein winding or unwinding the surgical cable around the input controller causes movement of the surgical wrist.

[0166] Clause 16. The surgical wrist as described in Clause 12, wherein the telescoping device further comprises at least one differential configured to rotate about an operating axis to maintain the length of the surgical cable.

[0167] Clause 17. The surgical wrist as described in Clause 12, further comprising a support bracket for mounting the input controller and the surgical wrist.

[0168] Clause 18. The surgical wrist as described in Clause 12 further includes a manipulator, wherein the manipulator includes at least N+1 motors for controlling the at least N+1 input controllers, the manipulator being removably attachable to the support bracket.

[0169] Clause 19. The surgical wrist as described in Clause 12, wherein the telescoping device is coupled to at least one of the surgical cables and at least one of the input controllers, the telescoping device being configured to maintain a constant length of the cable when the surgical wrist is not attached to a manipulator.

[0170] Clause 20. The surgical instrument according to Clause 1, wherein at least one of the cables is connected via the surgical actuator to a pair of input controllers, such that actuation of the pair of input controllers causes movement of the end effector.

[0171] Clause 21. The surgical instrument according to Clause 20, wherein at least one of the cables is connected to the pair of input controllers via the telescoping mechanism, such that actuation of the pair of input controllers causes movement of the telescoping mechanism, wherein the movement of the telescoping mechanism is a reciprocating motion of the end effector.

[0172] Clause 22. The surgical instrument according to Clause 1, wherein the telescoping device comprises N degrees of freedom, each of the N degrees of freedom corresponding to one of the N degrees of freedom of the end effector, wherein a movement of the end effector in any of the N degrees of freedom of the end effector causes a reciprocating motion in the corresponding degree of freedom of the telescoping device in the N degrees of freedom.

[0173] Clause 23. The surgical instrument according to Clause 1, wherein the at least N+1 independently operable input controllers are grouped into pairs, wherein one of the pairs is configured to wrap around the other, and the other of the pairs is configured to unwrap.

[0174] Clause 24. The surgical instrument according to Clause 23, wherein for each of the pairs, each of the independently operable input controllers is connected to the opposite end of one of the at least one cables connected to the surgical actuator.

[0175] Clause 25. A surgical instrument comprising:

[0176] A surgical actuator having at least N degrees of freedom, the surgical actuator being used to manipulate an object at a surgical site;

[0177] At least N+1 independently operable input controllers are configured to control the surgical actuator;

[0178] The telescopic joint includes at least one differential; and

[0179] Multiple components, the multiple components being configured such that an actuation of the input controller manipulates the components, the components being further configured such that:

[0180] At least one component connects at least one input controller to the surgical actuator, such that manipulation of the at least one component using the at least one input controller causes the surgical actuator to move; and

[0181] At least one component connects the telescopic member to at least one input controller in the input controller, such that manipulation of the at least one component using the at least one input controller causes the telescopic member to move.

[0182] Clause 26. A surgical instrument comprising:

[0183] A surgical actuator having a wrist configured to manipulate an object at a surgical site;

[0184] One or more robot-operable input controllers configured to open and close the wrist of the surgical actuator; and

[0185] A manual actuator configured to open and close the wrist of the surgical actuator.

[0186] Clause 27. The surgical instrument according to Clause 26, wherein the manual actuator is configured to control the wrist of the surgical actuator by rotating the telescoping mechanism.

[0187] Clause 28. The surgical instrument according to Clause 27, wherein the manual actuator has a set of gear teeth on an inner surface, the set of gear teeth being configured to mesh with a set of gear teeth on an outer surface of the telescoping device.

[0188] Clause 29. The surgical instrument according to Clause 27, wherein the manual actuator is configured to slide along a cover receiving the telescopic member to rotate the telescopic member.

[0189] Clause 30. The surgical instrument according to Clause 29, wherein the cover and the manual actuator are movable relative to the one or more robotically operable input controllers.

[0190] Clause 31. A surgical instrument comprising:

[0191] A surgical actuator configured to manipulate an object at a surgical site;

[0192] Multiple robot-operable input controllers, coupled to the telescopic unit and configured to control the surgical actuator; and

[0193] A manual actuator, operable to control the surgical actuator via movement of the telescoping mechanism.

[0194] Clause 32. The surgical instrument according to Clause 31, wherein the manual actuator is configured to control the degrees of freedom of the surgical actuator.

[0195] Clause 33. The surgical instrument according to Clause 32, wherein the manual actuator is configured to control the degree of freedom by rotating the telescoping mechanism.

[0196] Clause 34. The surgical instrument according to Clause 31, wherein the manual actuator has an internal engagement interface configured to engage the external engagement interface of the telescoping device.

[0197] Clause 35. The surgical instrument according to Clause 34, wherein the manual actuator is configured to move in a first direction to actuate the telescoping device, and wherein the height of at least one of the internal engagement interface or the external engagement interface allows the manual actuator to move along the engagement interface in a second direction transverse to the first direction and maintain engagement between the internal engagement interface and the external engagement interface.

[0198] Clause 36. The surgical instrument according to Clause 35, wherein the internal engagement interface includes a first set of gear teeth, the external engagement interface includes a second set of gear teeth complementary to the first set of gear teeth, and the height corresponds to the tooth width of at least one of the first set of gear teeth or the second set of gear teeth.

[0199] Clause 37. A surgical instrument comprising:

[0200] A surgical actuator configured to manipulate an object at a surgical site;

[0201] One or more input controllers, the one or more input controllers being configured to control the surgical actuator;

[0202] Coverings; and

[0203] A manual actuator configured to control the surgical actuator via the cover.

[0204] Clause 38. The surgical instrument according to Clause 37 further includes a support base supporting the one or more input controllers, wherein the cover and the manual actuator are configured to move together with respect to the support base.

[0205] Clause 39. The surgical instrument according to Clause 37, wherein the manual actuator includes an engagement interface within the cover and a user-operable portion exposed outside the cover, the engagement interface being configured to engage a telescoper.

[0206] Clause 40. The surgical instrument according to Clause 39, wherein the user-operable portion is a tab that projects outward from the cover.

[0207] Clause 41. The surgical instrument according to Clause 40, wherein the tab is slidable along a slot in the cover.

[0208] Clause 42. The surgical instrument according to Clause 37, wherein the manual actuator is slidably supported by the cover.

[0209] Upon reading this disclosure, those skilled in the art will understand alternative structural and functional designs based on the principles disclosed herein. Therefore, while specific embodiments and applications have been illustrated and described, it should be understood that the disclosed embodiments are not limited to the precise constructions and components disclosed herein. It will be apparent to those skilled in the art that various modifications, alterations, and variations can be made to the arrangement, operation, and details of the methods and apparatus disclosed herein without departing from the spirit and scope defined in the appended claims.

[0210] As used herein, any reference to “an embodiment” or “implementation” means that a particular element, feature, structure, or characteristic described in connection with an embodiment is included in at least one embodiment. The phrase “in an embodiment” appearing throughout the specification does not necessarily refer to the same embodiment.

[0211] Some implementations may use the terms “connection” and “joint” along with their derivatives for description. For example, some implementations may use the term “connection” to indicate that two or more elements are in direct physical or electrical contact. However, the term “connection” may also mean that two or more elements are not in direct contact with each other, but rather cooperate or interact with each other. Unless otherwise explicitly stated, implementations are not limited to this context.

[0212] As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having,” or any other variation thereof are intended to cover non-exclusive inclusion. For example, a process, method, article, or apparatus that includes a list of elements is not necessarily limited to those elements, but may include other elements not expressly listed or inherent in such a process, method, article, or apparatus. Furthermore, unless expressly stated otherwise, “or” refers to an inclusive or rather than an exclusive or. For example, conditions A or B are satisfied by any of the following: A is true (or exists) and B is false (or does not exist); A is false (or does not exist) and B is true (or exists); and both A and B are true (or exist).

[0213] Furthermore, the terms "an" or "a" are used to describe elements and components of the embodiments herein. This is done for convenience only and to give a general meaning of the invention. The description should be understood to include one or at least one, and unless explicitly indicated otherwise, the singular includes the plural.

Claims

1. A surgical instrument, comprising: A surgical actuator having a wrist configured to manipulate an object at a surgical site; One or more robot-operable input controllers are coupled to the telescoper and configured to open and close the wrist of the surgical actuator; and A manual actuator configured to open and close the wrist of the surgical actuator; When the surgical instrument is separated from the instrument manipulator and the robotic arm, the manual actuator is configured to control the wrist of the surgical actuator by rotating the telescopic unit, while the one or more robot-operable input controllers are configured to maintain the length of the cable in the telescopic unit.

2. The surgical instrument of claim 1, wherein the manual actuator has a set of gear teeth on an inner surface, the set of gear teeth being configured to mesh with a set of gear teeth on an outer surface of the telescoping device.

3. The surgical instrument of claim 1, wherein the manual actuator is configured to slide along a cover accommodating the telescopic member to rotate the telescopic member.

4. The surgical instrument of claim 3, wherein the cover and the manual actuator are movable relative to the one or more robot-operable input controllers.

5. A surgical instrument, comprising: A surgical actuator configured to manipulate an object at a surgical site; Multiple robot-operable input controllers are coupled to the telescopic unit and configured to control the surgical actuator; and A manual actuator, operable to control the surgical actuator via movement of the telescopic member; When the surgical instrument is separated from the instrument manipulator and the robotic arm, the manual actuator is configured to control the surgical actuator by rotating the telescopic unit, while the plurality of robot-operable input controllers are configured to maintain the length of the cables in the telescopic unit.

6. The surgical instrument of claim 5, wherein the manual actuator is configured to control the degrees of freedom of the surgical actuator.

7. The surgical instrument of claim 6, wherein the manual actuator is configured to control the degree of freedom by rotating the telescoping mechanism.

8. The surgical instrument of claim 5, wherein the manual actuator has an internal engagement interface configured to engage the external engagement interface of the telescopic device.

9. The surgical instrument of claim 8, wherein the manual actuator is configured to move in a first direction to actuate the telescoping device, and wherein the height of at least one of the internal engagement interface or the external engagement interface allows the manual actuator to move in a second direction transverse to the first direction and maintain engagement between the internal engagement interface and the external engagement interface.

10. The surgical instrument of claim 9, wherein the internal engagement interface includes a first set of gear teeth, the external engagement interface includes a second set of gear teeth complementary to the first set of gear teeth, and the height corresponds to the tooth width of at least one of the first set of gear teeth or the second set of gear teeth.

11. A surgical instrument comprising: A surgical actuator configured to manipulate an object at a surgical site; One or more input controllers are coupled to the telescopic unit and configured to control the surgical actuator; A cover configured to accommodate the telescopic member; and A manual actuator configured to control the surgical actuator by movement of the cover via the telescoping mechanism; When the surgical instrument is separated from the instrument manipulator and the robotic arm, the manual actuator is configured to control the surgical actuator by rotating the telescopic unit, while the one or more input controllers are configured to maintain the length of the cable in the telescopic unit.

12. The surgical instrument of claim 11, further comprising a support base supporting the one or more input controllers, wherein the cover and the manual actuator are configured to move together with respect to the support base.

13. The surgical instrument of claim 11, wherein the manual actuator includes an engagement interface within the cover and a user-operable portion exposed outside the cover, the engagement interface being configured to engage the telescopic actuator.

14. The surgical instrument of claim 13, wherein the user-operable portion is a tab projecting outward from the cover.

15. The surgical instrument of claim 14, wherein the tab is slidable along a slot in the cover.

16. The surgical instrument of claim 11, wherein the manual actuator is slidably supported by the cover.

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